Serum aspirin esterase activity is lower in end-stage renal disease patients than in healthy control subjects and increases after haemodialysis

Abstract

Background: Studies regarding aspirin metabolism can be important in patients with renal failure who have an increased risk of cardiovascular diseases. We undertook this study to assess the aspirin esterase (AE) status in end-stage renal disease (ESRD) patients. Methods: A total of 42 patients on long-term haemodialysis (HD) with a mean dialysis course of 6.1 y were recruited. Results: Serum AE levels were 44% lower and cholinesterase (ChE) levels were 22% lower in ESRD patients before dialysis as compared with control subjects (P ¼ 0.0001). A very strong correlation was found between AE and ChE levels. AE levels increased on average 28% after dialysis with adjustments for age, gender, total cholesterol, triglyceride and high-density lipoprotein cholesterol (P ¼ 0.002). In addition, ChE levels were significantly increased (48%) after dialysis (P ¼ 0.0001). Changes in AE activity were significantly and positively correlated with those of ChE (r ¼ 0.427, P ¼ 0.005). When we adjusted for several confounders, we found that the changes in AE activity operated by dialysis are significant independently of age, gender, aspirin (ASA) intake, cholesterol, triglycerides, high-density lipoprotein cholesterol and ChE. Conclusions: We report that serum AE activity is significantly lower in ESRD and that treatment by HD results in an increase of activity. We confirm that AE is associated with lipid parameters and ChE. Our results show variations in ASA catabolism between the dialysis sessions, suggesting an oscillating pattern in ASA disposal in these patients. The mechanisms for reduced AE activity in uraemia and the effects of HD need further investigation.

Effectiveness and Safety of Antiplatelet in Stroke Patients with End-Stage Renal Disease Undergoing Dialysis

“…Aspirin and clopidogrel are the antiplatelet drugs most often recommended for long-term use in preventing IS and decreasing its recurrence in the general population (16,17). However, because both aspirin and clopidogrel are excreted through the kidney, the concentration of these drugs may exacerbate renal dysfunction (18–20). Because of the decreased renal function in ESRD patients undergoing dialysis, an evaluation of the effectiveness and safety of these substances is difficult in them.…”

Investigation into the causes of aspirin resistance in healthy dogs

“…High variability (12‐fold) has been demonstrated in a large study serum aspirin esterase activities in humans that were partially explained by butyrylcholinesterase gene polymorphism (Adebayo, Williams, & Healy, ). Decreased serum aspirin esterase activity has also been shown in human patients with renal disease (Gugliucci et al., ). Future studies are needed in dogs to evaluate variation in serum aspirin esterase.…”